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[结直肠癌的外科治疗结果:400例患者的复发与生存分析]

[Results of the surgical treatment of colorectal cancer: analysis of recurrence and survival in 400 patients].

作者信息

Bannura G, Contreras J, Cumsille M A, García C, Portalier P

机构信息

Departamento de Cirugía, Hospital Clínico San Borja Arriaran, Santiago de Chile.

出版信息

Rev Med Chil. 1995 Apr;123(4):464-72.

PMID:8525191
Abstract

We analyzed retrospectively the long term survival and recurrence of 400 patients with colorectal cancer operated in a period of 13 years. Kaplan Meier curves were used for survival analysis and Cox's regression for multivariate analysis. Ninety eight percent of 377 surviving patients were followed for a mean period of 34 +/- 36 months (range 12-156). Global recurrence was 32% and higher for rectal than colon cancer. Sixty five percent of recurrences were distant. The main prognostic parameter for recurrence was peritumoral lymph node involvement. The initial tumoral stage was the main prognostic factor for survival. Five years survival probability was 94.4% in stage A, 81.3% in stage B, 63.8% in stage C1, 41.3% in stage C2 and 3.1% in stage D. Preoperative radiation therapy did not improve survival or recurrence. Postoperative radiation therapy prolonged the lapse between surgery and recurrence, without changing overall survival. The prolonged survival of some patients in stage D justifies palliative surgery in this stage.

摘要

我们回顾性分析了13年间接受手术治疗的400例结直肠癌患者的长期生存及复发情况。采用Kaplan-Meier曲线进行生存分析,Cox回归进行多因素分析。377例存活患者中,98%接受了平均34±36个月(范围12 - 156个月)的随访。总体复发率为32%,直肠癌的复发率高于结肠癌。65%的复发为远处转移。肿瘤周围淋巴结受累是复发的主要预后参数。初始肿瘤分期是生存的主要预后因素。A期患者5年生存概率为94.4%,B期为81.3%,C1期为63.8%,C2期为41.3%,D期为3.1%。术前放疗未改善生存或复发情况。术后放疗延长了手术至复发的间隔时间,但未改变总体生存率。D期部分患者的长期生存证明了该期姑息性手术的合理性。

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